Optimal Tube Feeding Method in Head and Neck Cancer Patients
| Status: | Suspended |
|---|---|
| Conditions: | Cancer, Cancer |
| Therapuetic Areas: | Oncology |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 2/4/2017 |
| Start Date: | February 2015 |
| End Date: | February 2017 |
The Optimal Tube Feeding Method in Head and Neck Cancer Patients: A Comparison Between Bolus, Gravity, and Tube Feeding Pump.
The purpose of this study is to assess the optimal tube feeding method (bolus, gravity or
pump) by analyzing percent weight loss, tolerance of enteral feeds, and percent of estimated
calorie and protein needs in 60 patients with squamous cell carcinoma of the head and neck
undergoing chemoradiation therapy.
pump) by analyzing percent weight loss, tolerance of enteral feeds, and percent of estimated
calorie and protein needs in 60 patients with squamous cell carcinoma of the head and neck
undergoing chemoradiation therapy.
It is a great challenge to maintain the nutritional status of the head and neck cancer (HNC)
patients through treatment advances such as combined chemoradiation therapy or CRT. For all
these reasons, HNC patients undergoing treatment, frequently require alternate methods of
nutrition support such as as enteral tube feeding via a gastrostomy tube.Upon gastric tube
feeding initiation, the registered dietitian (RD) must consider the three different methods:
bolus (using a syringe), gravity (using gravity feeding bags), and pump (using a tube
feeding pump).
Typically, patients are started on bolus (OPTION A), changed to gravity (OPTION B) if bolus
feeds are not tolerated, and ultimately changed to pump (OPTION C) if gravity feeds are not
tolerated. The concern is that in this process of starting with OPTION A, and moving to
OPTION B or further to OPTION C, the patient may experience unintentional weight loss and
dehydration related to tube feeding intolerance and/or tube feeding inadequacy.
Consequently, this places the patient at risk of, but not limited to, hospital admission for
dehydration and/or malnutrition, and treatment interruption. Therefore, exploring the idea
of an optimal feeding method and starting patients on it from the beginning, may improve
patient outcomes in terms of nutritional status.
patients through treatment advances such as combined chemoradiation therapy or CRT. For all
these reasons, HNC patients undergoing treatment, frequently require alternate methods of
nutrition support such as as enteral tube feeding via a gastrostomy tube.Upon gastric tube
feeding initiation, the registered dietitian (RD) must consider the three different methods:
bolus (using a syringe), gravity (using gravity feeding bags), and pump (using a tube
feeding pump).
Typically, patients are started on bolus (OPTION A), changed to gravity (OPTION B) if bolus
feeds are not tolerated, and ultimately changed to pump (OPTION C) if gravity feeds are not
tolerated. The concern is that in this process of starting with OPTION A, and moving to
OPTION B or further to OPTION C, the patient may experience unintentional weight loss and
dehydration related to tube feeding intolerance and/or tube feeding inadequacy.
Consequently, this places the patient at risk of, but not limited to, hospital admission for
dehydration and/or malnutrition, and treatment interruption. Therefore, exploring the idea
of an optimal feeding method and starting patients on it from the beginning, may improve
patient outcomes in terms of nutritional status.
Inclusion Criteria:
- Males and females
- 18 years or older
- Diagnosis of SCCHN undergoing concurrent chemoradiation therapy (including patients
who received induction therapy upfront
Exclusion Criteria:
- Patients who have a small bowel feeding tube (only tube feeding via pump is allowed
in this case)
- Patients with history of gastric surgery which may have resulted in altered
gastrointestinal function
- Patients with history of uncontrolled diabetes and/or gastroparesis which may
interfere with gastric emptying and inability to tolerate bolus feeds
- Patients at high risk of aspiration in which case slower feeds by using gravity or
pump are indicated
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